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Evidence summaries

Chemotherapy for Advanced Endometrial Carcinoma

More intense chemotherapy regimens like cisplatin and doxorubicin may be effective for improving overall and progression-free survival than less intensive ones for advanced endometrial adenocarcinoma but at the expense of increased toxicity. Level of evidence: "C"

A Cochrane review [Abstract] 1 on cytotoxic chemotherapy in women with advanced, recurrent or metastatic endometrial adenocarcinoma included 14 studies, 8 of which compared 'more' with 'less' chemotherapy(n=1519). Treatment consisting of 'more' chemotherapy was associated with longer overall survival (OS) (hazard ratio (HR) 0.86; 95% confidence intervals (CI) 0.77 to 0.96; P = 0.005) and with longer progression-free survival (PFS) ( HR 0.82; 95% CI 0.74 to 0.90; n = 1526, P < 0.0001). However, serious acute toxicities were more common in women randomised to the more-intense chemotherapy regimens.

There was no evidence to suggest that any particular doublet chemotherapy was better (or worse) than any other, or that any single-agent chemotherapy was better (or worse) than another; however, data for these two comparisons were limited. There were no comparative trials of chemotherapy with endocrine therapy or best supportive care alone.

    References

    • Humber C, Tierney J, Symonds P, Collingwood M, Kirwan J, Williams C, Green J. Chemotherapy for advanced, recurrent or metastatic endometrial carcinoma. Cochrane Database Syst Rev 2005;(4):CD003915 [Assessed as up-to-date: 4 July 2012].

Primary/Secondary Keywords